This proposal is in response to a Request for Applications for the Neurological Emergencies Treatment Trials. This abstract summarizes the capability of the Oregon Health &Science University (OHSU) BRAINETT network to accomplish the specific aims of the RFA: - To develop an infrastructure to carry out clinical trials in neurological emergencies that are relevant to the clinical practice of both emergency medicine physicians and neuro-clinicians: BRAINETT represents a coalition of emergency physicians, pediatricians, neurologists, neurosurgeons, trauma surgeons, and neuro- Intensivists. To enhance the efficient conduct of clinical research in neurological emergencies by avoiding de novo creation of clinical trial infrastructure for each individual research project: BRAINETT builds on an existing research infrastructure that has supported 15 years of clinical trials of acute stroke at 10 hospitals and 15 years of Emergency Medicine research including participation in the 3 largest clinical trials ever conducted in the out-of-hospital setting. - To expedite recruitment by involving scores of emergency departments: BRAINETT will initially involve 4 EDs with a combined annual census of 216,000 visits, along with the EMS systems of 2 large and diverse counties. - To involve a wide spectrum of investigators, including those at smaller hospitals and in non-urban settings: The BRAINETT investigators have extensive clinical and research ties with Oregon hospitals, large and small, urban and rural, and can expand the network as needed. - To recruit a broad range of participants, particularly minorities: BRAINETT study sites reflect the range of patients seen in the communities they serve, as detailed in the application. - To facilitate the transfer of research results to clinical practice, especially to community hospital settings, and the general endorsement by emergency medicine physicians: OHSU's role as the only academic medical center in Oregon makes it an influence leader for Emergency Medicine and other specialties. - To foster the development and testing of innovative telemedicine methods to involve off-site specialists in the care of neurological disorders in emergency departments: OHSU has a strong track record of using telemedicine in rural Oregon and other remote communities. The BRAINETT team has the experience and resources to serve as a key participant in this important initiative.